No Neck Artery Damage From Chiropractic Manipulation

No Neck Artery Damage From Chiropractic Manipulation


  • Chiropractic physicians have been accused of damaging arteries in the neck with spinal manipulation.
  • Recent epidemiologic studies have called that assertion into question. In fact, research has proven that exposure to chiropractic manipulation causes no more damage to neck arteries than exposure to a general medical practitioner.
  • In this study, researchers measure the stress placed on vertebral arteries during cervical ROM and during manipulation.
  • Manipulation places less stress on a cervical artery than normal cervical rotation.
  • The stress an artery from cervical ROM and manipulation is much lower than the strain rates required to cause arterial failure.



Cervical ArterySpontaneous vertebral artery dissection has significant mortality and morbidity among young adults. Unfortunately, causal mechanisms remain unclear. The purpose of this study was to quantify mechanical strain in the vertebral artery while simultaneously capturing motion analysis data during passive movements of the head and neck relative to the trunk during spinal manipulation and cardinal planes of motion.


Eight piezoelectric crystals (four per vertebral artery) were sutured into the lumen of the left and right vertebral arteries of 3 cadaveric specimens. Strain was then calculated as changes in length between neighboring crystals from a neutral head/neck reference position using ultrasound pulses. Simultaneously, passive motion of the head and neck on the trunk was captured using eight infrared cameras. The instantaneous strain arising in the vertebral artery was correlated with the relative changes in head position.


Strain in the contralateral vertebral artery during passive flexion-rotation compared to that of extension-rotation is variable ([df=32]: -0.61<r<0.55). Peak strain does not coincide with peak angular displacement during spinal manipulation and cardinal planes of motion. Axial rotation displayed the greatest amount of strain. The greatest amount of strain achieved during spinal manipulation was comparably lower than strains achieved during passive end range motions and previously reported failure limits.


The results of this study suggest that vertebral artery strains during head movements including spinal manipulation, do not exceed published failure strains. This study provides new evidence that peak strain in the vertebral artery may not occur at the end range of motion, but rather at some intermediate point during the head and neck motion.


Piper, Howarth, Triano, Herzog. Quantifying strain in the vertebral artery with simultaneous motion analysis of the head and neck: a preliminary investigation. Clin Biomech (Bristol, Avon). 2014 Dec;29(10):1099-107. doi: 10.1016/j.clinbiomech.2014.10.004. Epub 2014 Oct 23.




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About Richard Cole

Richard L. Cole, DC, DACNB, DAAPM, FICCN, FICC is a doctor of chiropractic, with advanced training in chiropractic neurology and pain management. Also, he is a fellow of the International College of Chiropractic Neurology and a fellow of the International College of Chiropractors.